What happens when you are stressed?

Stress is what you feel when you have to handle more than you are used
to. When you are stressed, your body responds as though you are in danger. It
makes hormones that speed up your heart, make you breathe faster, and give you
a burst of energy. This is called the fight-or-flight
stress response.

Some stress is normal
and even useful. Stress can help if you need to work hard or react quickly. For
example, it can help you win a race or finish an important job on time.

But if stress happens too often or lasts too long, it can have bad
effects. It can be linked to headaches, an upset stomach, back pain, and
trouble sleeping. It can weaken your
immune system, making it harder to fight off disease.
If you already have a health problem, stress may make it worse. It can make you
moody, tense, or depressed. Your relationships may suffer, and you may not do
well at work or school.

What can you do about stress?

The good news is
that you can learn ways to manage stress. To get stress under control:

Find out what is causing stress in your
life.

Look for ways to reduce the amount of stress in your
life.

Learn healthy ways to relieve stress and reduce its harmful
effects.

How do you measure your stress level?

Sometimes it
is clear where stress is coming from. You can count on stress during a major
life change such as the death of a loved one, getting married, or having a
baby. But other times it may not be so clear why you feel stressed.

It's important to figure out what causes stress for you. Everyone feels
and responds to stress differently. Tracking your stress may help. Get a
notebook, and write down when something makes you feel stressed. Then write how
you reacted and what you did to deal with the stress. Tracking your stress can help you find out what is causing your stress and how much stress you feel.
Then you can take steps to reduce the stress or handle it better.

To find out how stressed you are right now, use this
Interactive Tool: What Is Your Stress Level?

How can you avoid stress?

Stress is a fact of life
for most people. You may not be able to get rid of stress, but you can look for
ways to lower it.

You might try some of these ideas:

Learn better ways to manage your time. You
may get more done with less stress if you make a schedule. Think about which
things are most important, and do those first.

Find better ways to
cope. Look at how you have been dealing with stress. Be honest about what works
and what does not. Think about other things that might work better.

Take good care of yourself. Get plenty of rest. Eat well. Don't
smoke. Limit how much alcohol you drink.

Try out new ways of
thinking. When you find yourself starting to worry, try to stop the thoughts.
Or write down your worries and work on letting go of things you cannot change. Learn to say "no."

Speak up. Not being able to talk about your needs and concerns
creates stress and can make negative feelings worse. Assertive communication
can help you express how you feel in a thoughtful, tactful way.

Ask
for help. People who have a strong network of family and friends manage stress
better.

Sometimes stress is just too much to handle alone.
Talking to a friend or family member may help, but you may also want to see a
counselor.

How can you relieve stress?

You will feel better if
you can find ways to get stress out of your system. The best ways to relieve
stress are different for each person. Try some of these ideas to see which ones
work for you:

Exercise. Regular exercise is one of the best
ways to manage stress. Walking is a great way to get started.

Write. It can help to write about the things that are bothering you.

Let your feelings out. Talk, laugh, cry, and express anger when
you need to with someone you trust.

Do something you enjoy. A
hobby can help you relax. Volunteer work or work that helps others can be a
great stress reliever.

Focus on the present. Try meditation, imagery exercises, or
self-hypnosis. Listen to relaxing music. Try to look for the humor in life.
Laughter really can be the best medicine.

Health Tools help you make wise health decisions or take action to improve your health.

Actionsets are designed to help people take an active role in managing a health condition.

Insomnia: Improving Your Sleep

Stop Negative Thoughts: Getting Started

Stress Management: Breathing Exercises for Relaxation

Stress Management: Doing Guided Imagery to Relax

Stress Management: Doing Meditation

Stress Management: Doing Progressive Muscle Relaxation

Stress Management: Managing Your Time

Stress Management: Practicing Yoga to Relax

Stress Management: Reducing Stress by Being Assertive

Stress Management: Relaxing Your Mind and Body

Interactive tools are designed to help people determine health risks, ideal weight, target heart rate, and more.

Interactive Tool: How Well Do You Bounce Back?

Interactive Tool: What Is Your Stress Level?

Learning about stress:

What is stress?

What causes it?

What are the signs of stress?

What is job stress?

Effects of stress:

Why is stress a problem?

Is there a link between stress and illness?

How does stress affect children and teens?

How does being a caregiver or having a family member with a chronic disease affect family stress?

Evaluating stress:

How do I evaluate my stress?

How well do I deal with stress?

What is a stress record?

Relieving stress:

How can I relieve stress?

How can I reduce the stress of caregiving?

How can I reduce holiday stress?

How can I avoid unnecessary stress?

How is problem solving used to manage stress?

What professional help is available?

How can I relax?

How can I do progressive muscle relaxation to relax?

How can I meditate to relax?

What breathing exercises can I do to relax?

How can I do guided imagery to relax?

How can I manage my time better?

How can I do yoga to relax?

How can I be more assertive?

A lot of things can cause
stress. You may feel stress when you go on a job
interview, take a test, or run a race. These kinds of short-term stress are
normal. Long-term (chronic) stress is caused by stressful situations or events
that last over a long period of time, like problems at work or conflicts in
your family. Over time, chronic stress can lead to severe health problems.

Personal problems that can cause stress

Your health, especially
if you have a chronic illness such as heart disease,
diabetes, or
arthritis

Your relationships, such as
having problems with your relationships or feeling a lack of friendships or
support in your life

Major life changes, such as dealing with
the death of a parent or spouse, losing your job, getting married, or moving to
a new city

Stress in your family, such as
having a
child, teen, or other family member who is under
stress, or being a caregiver to a family member who is elderly or who has
health problems

Conflicts with your beliefs and values.
For example, you may value family life, but you may not be able to spend as
much time with your family as you want.

Social and job issues that can cause
stress

Your surroundings. Living in an area where
overcrowding, crime, pollution, or noise is a problem can create chronic
stress.

Your social situation. Not having enough money to cover your expenses, feeling lonely, or facing discrimination
based on your race, gender, age, or sexual orientation can add stress to your
life.

Your job. Being unhappy with your
work or finding your job too demanding can lead to chronic stress. Learn how to
manage job stress.

Unemployment. Losing your job or not being able to find work can also add to your stress level.

Post-traumatic stress

You may need help dealing
with stress if you have faced a life-threatening or traumatic event such as
rape, a natural disaster, or war. These events can cause
acute stress disorder or
post-traumatic stress disorder (PTSD). For more
information, see the topic
Post-Traumatic Stress Disorder.

Stress causes
changes in your body. It also affects your emotions.

How stress affects the body

Common symptoms of
stress include:

A fast heartbeat.

A
headache.

A stiff neck and/or tight shoulders.

Back
pain.

Fast breathing.

Sweating, and sweaty palms.

An upset stomach, nausea, or diarrhea.

Over time, stress can affect your:1

Immune system. Constant stress can make
you more likely to get sick more often. And if you have a chronic illness such
as
AIDS, stress can make your symptoms
worse.

Skin. Skin problems such as
acne and
psoriasis are made worse by stress.

An extreme reaction to stress is a panic attack. A panic attack is a sudden, intense fear or anxiety that may make you feel short of breath, dizzy, or make your heart pound. People who have panic attacks may feel out of control, like they are having a heart attack, or are about to die. Panic attacks may happen with no clear cause, but they can be brought on by living with high levels of stress for a long time. For more information on panic attacks, see the topic Panic Attacks and Panic Disorder.

How stress affects your thoughts and emotions

You might notice signs of stress in the way you
think, act, and feel. You may:

Feel cranky and unable to deal with even
small problems.

Feel frustrated, lose your temper more often, and
yell at others for no reason.

Feel jumpy or tired all the
time.

Find it hard to focus on tasks.

Worry too much
about small things.

Feel that you are missing out on things because
you can't act quickly.

Imagine that bad things are happening or
about to happen.

How stress affects you depends on many things, such
as:

Your personality.

What you have learned from your family about responding to
stress.

How you think about and handle stress.

Your
coping strategies(What is a PDF document?).

Your social
support.

The type of stress matters

Stress can affect you
both instantly (acute stress) and over time (chronic stress).

Acute (short-term) stress is the body's instant
response to any situation that seems demanding or dangerous. Your stress level
depends on how intense the stress is, how long it lasts, and how you cope with
the situation.

Most of the time, your body recovers quickly from
acute stress. But stress can cause problems if it happens too often or if your
body doesn't have a chance to recover. In people with heart problems, acute
stress can trigger an abnormal heartbeat (arrhythmia) or
even a
heart attack.

Chronic (long-term) stress is caused by stressful situations or events that last
over a long period of time. This could include having a difficult job or
dealing with a chronic disease. If you already have a health problem, stress
can make it worse.

Feeling
stress is a fact of life for most people. But it
affects everyone differently. What causes stress for you may not be stressful
for someone else. That's because how you view a situation affects how much
stress it causes you. Only you can figure out whether you have too much stress
in your life.

Ask yourself these questions to find out what is
causing your stress:

What job, family, or personal stress do you have?

Stress can be caused by an ongoing personal situation such as:

Problems in your family or with a
relationship.

Caring for a family member who is elderly, has
chronic health problems, or is disabled. Caregiving is a major source of
stress.

For more information, see the topic
Quick Tips: Reducing the Stress of Caregiving.

Your job.

Dealing with a
family member who is under stress.

Have you had any recent major life changes?

Life
changes such as getting married, moving to a new city, or losing a job can all
be stressful. You can't always control these things, but you can control how
you respond to them.

To find out your current stress level based
on recent changes in your life, try this
Interactive Tool: What Is Your Stress Level?

Do your beliefs cause you stress?

Some people feel
stress because their beliefs conflict with the way they are living their life.
Examine your beliefs, such as your values and life goals, to find out if you have this kind
of conflict in your life.

How are you coping with stress?

Your lifestyle
choices can prevent your body from recovering from stress. For example, as you
sleep, your body recovers from the stresses of the day. If you're not getting
enough sleep or your sleep is often interrupted, you lose the chance to recover
from stress.

The way you act and behave can also be a sign of
stress. Some people who face a lot of stress react by smoking, drinking too
much alcohol, eating poorly, or not exercising. The health risks posed by these
habits are made even worse by stress.

Your body feels
stress-related wear and tear in two ways: the stress itself and the unhealthy
ways you respond to it.

Use this
coping strategies evaluation form(What is a PDF document?) to help you find out how you cope with
stress.

Try this
Interactive Tool: How Well Do You Bounce Back? It
measures your ability to deal with life's challenges.

The best way to manage your
stress is to learn healthy
coping strategies. You can start practicing these tips
right away. Try one or two until you find a few that work for you. Practice
these techniques until they become habits you turn to when you feel stress. You
can also use this
coping strategies form(What is a PDF document?) to see how you respond to stress.

Stress-relief techniques focus on relaxing your mind and your body.

Ways to relax your mind

Write. It may help to
write about things that are bothering you. Write for 10 to 15 minutes a day
about stressful events and how they made you feel. Or think about tracking your
stress. This helps you find out what is
causing your stress and how much stress you feel. After you know, you can find
better ways to cope.

Let your feelings out.
Talk, laugh, cry, and express anger when you need to. Talking with friends,
family, a counselor, or a member of the clergy about your feelings is a healthy
way to relieve stress.

Do something you enjoy. You may feel that you're too busy to do these things. But
making time to do something you enjoy can help you relax. It might also help
you get more done in other areas of your life. Try:

A hobby, such as gardening.

A creative activity,
such as writing, crafts, or art.

Playing with and caring for pets.

Volunteer work.

Focus on the present. Meditation and guided imagery are two
ways to focus and relax your mind.

Meditate. When you
meditate, you focus your attention on things that are happening right now.
Paying attention to your breathing is one way to focus. Mindfulness-based stress reduction is one form of meditation that is very helpful with managing stress and learning how to better cope with it.

Stress Management: Doing Meditation

Use guided imagery. With guided
imagery, you imagine yourself in any setting that helps you feel calm and
relaxed. You can use audiotapes, books, or a teacher to guide you.

Stress Management: Doing Guided Imagery to Relax

Ways to relax your body

Exercise. Regular exercise is one of the
best ways to manage stress. Walking is a great way to get started. Even
everyday activities such as housecleaning or yard work can reduce stress.
Stretching can also relieve muscle tension. For more information about becoming
more active, see the topic
Fitness.

Breathing exercises. These include
roll breathing, a type of deep breathing.

Stress Management: Breathing Exercises for Relaxation

Progressive muscle relaxation. This
technique reduces muscle tension. You do it by relaxing separate groups of
muscles one by one.

Stress Management: Doing Progressive Muscle Relaxation

Yoga,
tai chi, and qi gong. These techniques combine exercise and meditation. You
may need some training at first to learn them. Books and videos are also
helpful. You can do all of these techniques at home.

Stress Management: Practicing Yoga to Relax

You might like to try a combination of these techniques.

Stress Management: Relaxing Your Mind and Body

In addition to practicing these skills, you might also try some
other techniques to reduce stress, such as massage or music therapy.

Stress is a
part of life, and you can't always avoid it. But you can try to avoid
situations that can cause it, and you can control how you respond to it. The
first step is knowing your own
coping strategies. Try tracking your stress to record stressful events, your
response to them, and how you coped.

After you know what is
causing your stress, try making some changes in your life that will help you
avoid stressful situations. Here are a few ideas:

Manage your time

Time management is a way to find
the time for more of the things you want and need to do. It helps you decide
which things are urgent and which can wait. Managing your time can make your
life easier, less stressful, and more meaningful.

Stress Management: Managing Your Time

Look at your lifestyle

The choices you make
about the way you live affect your stress level. Your lifestyle may not cause
stress on its own, but it can prevent your body from recovering from it. Try
to:

Find a balance
between personal, work, and family needs. This isn't easy. Start by looking at
how you spend your time. Maybe there are things that you don't need to do at
all. Finding a balance can be especially hard during the holidays.

Quick Tips: Reducing Holiday Stress

Have a sense of purpose in life. Many people find meaning through connections with family or friends,
jobs, their spirituality, or volunteer work.

Get enough sleep. Your body recovers
from the stresses of the day while you are sleeping. If your worries keep you from sleeping, keep a notepad or your cell phone by your bed to record what you are worried about—to help you let it go while you sleep. For example, if you are worried you might forget to run an errand the next day, make a note so that you can stop worrying about forgetting.

Insomnia: Improving Your Sleep

Adopt healthy habits. Eat a healthy diet, limit how much alcohol you drink, and don't smoke. Staying
healthy is your best defense against stress.

Exercise. Even
moderate exercise, such as taking a daily walk, can
reduce stress.

Get support

Support in your life from family,
friends, and your community has a big impact on how you experience stress.
Having support in your life can help you stay healthy.

Support
means having the love, trust, and advice of others. But support can also be
something more concrete, like time or money. It can be hard to ask for help.
But doing so doesn't mean you're weak. If you're feeling stressed, you can look
for support from:

Family and friends.

Coworkers,
or people you know through hobbies or other interests.

A
professional counselor. (See
tips for finding a counselor or therapist.)

People you know from
church, or a member of the clergy.

Employee assistance programs at
work, or stress management classes.

Support groups. These can be
very helpful if your stress is caused by a special situation. Maybe you are a
caregiver for someone who is elderly or has a chronic illness.

Quick Tips: Reducing the Stress of Caregiving

Change your thinking

Stressful events can make
you feel bad about yourself. You might start focusing on only the bad and not
the good in a situation. That's called negative thinking. It can make you feel
afraid, insecure, depressed, or anxious. It's also common to feel a lack of
control or self-worth.

Negative thinking can trigger your
body's
stress response, just as a real threat does. Dealing
with these negative thoughts and the way you see things can help reduce stress.
You can learn these techniques on your own, or you can get help from a
counselor. Here are some ideas:

Cognitive-behavior therapy (CBT) helps you cope with a
problem by changing the way you think. How you think affects how you feel. To learn more, see
the topic
Stop Negative Thoughts: Choosing a Healthier Way of Thinking.

Stop Negative Thoughts: Getting Started

Problem solving helps you identify all aspects of a
stressful event, find things you may be able to change, and deal with things
you can't change.

Assertive communication helps you
express how you feel in a thoughtful, tactful way. Not being able to talk about
your needs and concerns creates stress and can make negative feelings worse.

Stress Management: Reducing Stress by Being Assertive

Setting a goal in three steps

If you're ready to
reduce
stress in your life, setting a goal may help. Try
following these three steps:

Find out what creates stress for you. Try tracking your stress to record stressful events, your
response to them, and the coping strategies you used. If you have a smartphone, you can download a free stress-tracking app to help you monitor your stress. If you don't have a smartphone, you can use a spreadsheet on your computer. Or pencil and paper work, too. The important thing is to keep track of your stress so that you can both learn what is causing it and work toward managing it.

Think about why you want to reduce stress. You might want to protect your heart and
your health by reducing stress. Or maybe you simply want to enjoy your life
more and not let stress control how you feel. Your reason for wanting to change
is important. If your reason comes from you—and not someone else—it will be
easier for you to make a healthy change for good.

Set a goal. Think about a long-term and a short-term goal to
reduce stress in your life.

Examples of how to set goals

Sheila is a customer service manager for a
computer company. She's also the mother of two young kids. Between her job and
chores at home, she feels overwhelmed by all the demands on her. She can't
remember the last time she took a lunch break at work or took a class at the
gym. While she's lying awake at night, she is worrying about getting everything
done. Sheila's long-term goal: Find a better balance between personal, home,
and family needs. Short-term goal: Take a 15-minute walk each night.

Stress Management: Managing Your Time

Ray is a pretty easygoing guy most of the time.
But he gets stressed over small things. If a problem comes up at work, he
spends the whole night thinking about it over and over. He feels anxious
wondering how he could have handled things better. Ray knows he needs to let go
of these events and move on. Ray's long-term goal: Practice positive thinking
when stressful events come up. Short-term goal: Try breathing and relaxation
exercises when he feels stressed.

Stop Negative Thoughts: Getting Started

Stress Management: Relaxing Your Mind and Body

Marta is a full-time caregiver for her elderly
mother, who has
Alzheimer's disease. Marta can't remember the last
time she took a vacation or even met a friend for coffee. Her sister helps with
care sometimes but is often too busy. Marta finds herself getting frustrated
easily. She needs a break. Marta's long-term goal: Involve her sister more in
caregiving. She also plans to find respite care so she isn't providing all the
caregiving on her own. Short-term goal: Attend a caregiver support group every
week.

Quick Tips: Reducing the Stress of Caregiving

Tips for staying on track

Plan for setbacks. Make
a personal action plan(What is a PDF document?) by writing down your goals, any
possible barriers, and your ideas for getting past them. By thinking about
these barriers now, you can plan ahead for how to deal with them if they
happen.

Get support. Tell family and friends
your reasons for wanting to change. Tell them that their encouragement makes a
big difference to you in your goal to reduce stress. Your doctor or a
professional counselor can also provide support. A counselor can help you set
goals and provide support in dealing with setbacks. (See
tips for finding a counselor or therapist.)

Pat yourself on the back. Don't forget to give yourself some positive
feedback. If you slip up, don't waste energy feeling bad about yourself.
Instead, think about all the times you've avoided getting stressed by making
changes.

Stress can be hard to deal with on your own. It's okay
to seek help if you need it. Talk with your doctor about the stress you're
feeling and how it affects you. A licensed counselor or other health
professional can help you find ways to reduce stress symptoms. He or she can
also help you think about ways to reduce stress in your life.

A counselor or health professional is useful for:

Cognitive-behavioral therapy (CBT). CBT teaches you to
be aware of how you perceive stress. It helps you understand that the way you
think about stress affects your response to it. CBT helps you create and use
skills to deal with stress. (See
tips for finding a counselor or therapist.)

Biofeedback. This technique teaches you how to use
your mind to control skin temperature, muscle tension, heart rate, or blood
pressure. All of these things can be affected by stress. Learning biofeedback
requires training in a special lab or a doctor's office.

Hypnosis. With
hypnosis, you take suggestions that may help you change the way you act. It's
important to find a health professional with a lot of training and experience.
Some psychologists, counselors, doctors, and dentists know how to use
hypnosis.

Treatment for other health problems

You may need
treatment for other emotional problems related to stress, such as
anxiety,
depression, or
insomnia. Treatment may include medicines or
professional counseling.

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